原发性肺淋巴瘤17例回顾性分析  

Primary Pulmonary Lymphoma: Retrospective Analysis of 17 Patients

作　　者：姚志华[1] 刘艳艳[1] 赵燕[1] 姚书娜[1] 郭宏强[1] 马杰[2] 夏庆欣[2] 杨树军[2] 

机构地区：[1]河南省肿瘤医院内科,郑州市450008 [2]河南省肿瘤医院病理科,郑州市450008

出　　处：《中国肿瘤临床》2011年第12期738-740,743,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨原发性肺淋巴瘤(PPL)的临床特点、确诊手段、病理及治疗、预后。方法:回顾性分析1999年6月至2008年12月河南省肿瘤医院收治的17例原发性肺淋巴瘤患者的临床特点、诊断、病理类型、治疗,应用Kaplan-Meier法行生存分析和Log-rank检验法行差异显著性检验。统计学分析应用SPSS 10.0软件完成。结果:17例患者中7例女性,10例男性;年龄29～73岁,中位发病年龄56岁;按照WHO 2001淋巴瘤病理分类系统,全组患者均为非霍奇金淋巴瘤,其中9例为黏膜相关淋巴组织淋巴瘤(MALTL);PPL占同期收治恶性淋巴瘤病例教的0.81%,占同期收治原发于结外淋巴瘤病例数的4.74%;随访5.2～93个月,中位随访时间为62.5个月。全组患者5年总生存率为62.5%,黏膜相关淋巴组织淋巴瘤(MALTL)和非黏膜相关淋巴组织淋巴瘤(non-MALTL)的5年总生存率分别为75%和50%,差异具有统计学意义(P=0.047)。结论:PPL临床上非常少见,症状及影像学表现不特异,容易误诊,获取足够具有代表性的组织标本进行病理学检查是确诊的关键。PPL的治疗原则尚无统一标准,由于其病理类型大多为低度恶性的MALT,因此预后较好。Objective： To discuss the clinical and pathological characteristics, diagnosis, treatment results, and prognosis of primary pulmonary lymphoma （ PPL ）. Methods： The clinical characteristics, diagnostic approaches, pathologic subtypes, and treatment of 17 PPL cases treated at the Tumor Hospital of He＇nan between June 1999 and December 2008 were retrospectively analyzed. The Ka- plan-Meier method was used in the survival analysis, and the log-rank method was used in the statistical test. Results： Of the 17 patients, 7 were female and 10 were male, with a median age of 56 years （ 29-73 years ）. According to the WHO 2001 lymphoma classification system, all 17 cases of PPL were non-Hodgkin＇s lymphomas; 13 patients had mucosa-associated lymphoid tissue （ MALT ） lymphoma. PPL accounted for about 0.81% of malignant lymphomas and 4.74% of primary extranodal lymphomas during the same period at the Tumor Hospital of He＇nan. The median follow-up time was 62.5 months （ 5.2-93 months ）. The overall survival rate of the 17 patients was 62.5% at 5 years; the 5-year overall survival was superior among patients with MALT lymphoma compared with those with the non-MALT lymphoma （ the 5-year overall survival rates were 75% and 50%, respectively; P = 0.047 ）. Conclusion： The incidence of PPL is very low. It is easily misdiagnosed because of its nonspecific clinical and imaging manifestations. Acquiring enough representative tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no therapeutic consensus for these patients. Most of its pathologic subtypes are MALT lymphomas; hence, PPL generally has good prognosis.

关 键 词：淋巴瘤 肺 诊断 综合治疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]